Do I Need Stitches? Evaluating an Open Wound for Sutures Part 2

Part 1 covered evaluating a wound to decide if you need to seek emergency treatment for stitches. However, that’s only part of caring for an open wound; you also must properly clean the wound and get to a medical facility within a certain time frame. Remember, the most important thing to do when confronted with an open wound is to control bleeding . If the victim is not you, follow universal precautions , using personal protective equipment if available.

Cleaning an Open Wound

Once bleeding has been controlled, the open wound should be cleaned with mild soap and water (see illustration). Liquid soaps do a great job, and there is no need for fancy antibacterial soaps. Be sure to rinse the entire depth of the cut, and rinse the soap from the surface thoroughly.

Water sometimes has a tendency to sting. Saline solution (0.9% salt solution) can be a little easier on tender skin. Bottled water can do double duty in a first aid kit that’s tight on space or weight (you can wash with it or drink it), but saline solution is better for cleaning wounds and eyes.

Keeping a wound clean is as important as cleaning it the first time. If it seems a wound has become contaminated or dirty after it was been cleaned and dressed, remove the dressing and clean it again. Keeping a wound clean is the best way to avoid infection.

Cleaning an open wound can sometimes cause bleeding to return. The bleeding will be minor and should be easily stopped with direct pressure using a sterile – or at least clean – dressing. Once the bleeding has been stopped, it’s time to dress the wound.

Dressing an Open Wound

Don’t dress a wound without first cleaning it as well as possible. Do not dress a wound with visible contamination. If you can’t get it clean, leave it open and seek medical attention.
Once the wound is clean and not bleeding, dab a bit of antiseptic ointment on it to keep out the germs. Cover the wound lightly with an adhesive dressing. If body hair gets in the way of an adhesive dressing, you may wrap the extremity loosely with a wide roller gauze. Always change dressings every 12 hours.

For lacerations and incisions, pull the edges of the wound together and use butterfly enclosures to hold them. Avulsions with a flap of skin can be closed and butterfly enclosures applied as well. Apply antiseptic ointment over butterfly enclosures and cover with a bandage as above. Superficial wounds, those that are not deep enough to see subcutaneous (fatty) tissue, do not need butterfly enclosures.

If a wound resumes bleeding at any point, follow the steps to control bleeding. If bleeding doesn’t stop, you may need to seek medical attention. If at any point the victim gets pale, dizzy, or weak, call 911 and treat for shock.

How Long Do I Have to Get Stitches?

If stitches are necessary, you will need to keep the wound closed with butterfly enclosures until you can get to an emergency room or urgent care clinic. Remember always, keep it closed and keep it clean.
How much time you have depends on a number of factors. If the wound has a high likelihood of contamination, then you have about six (6) hours to get stitches before the wound will become too contaminated to stitch. Some wounds are not generally stitched because of severe contamination, human or animal bites are good examples.

Wounds with less chance of contamination may be stitched as long as eight (8) hours after the injury. Depending on the wound, scarring can be minimized as long as 24 hours after the injury, but the longer you wait, the less likely that stitches will be possible.

For wounds that have other complications like numbness or decreased movement, seek medical attention immediately.

Complications of Open Wounds

Infection is the most common complication of an open wound. If you experience any of the following symptoms after sustaining an open wound, consult a doctor:

Tenderness or inflammation around the wound
Fever
Swelling around the wound
Numbness around the wound
Red streaks around the wound

What is Tetanus?

Tetanus is a serious infection that can lead to spasms in the jaw – commonly called Lockjaw – and possibly death. It is easily blocked with a simple vaccination. If you haven’t had at least three tetanus vaccinations with the last being within ten (10) years, it’s time to get a tetanus shot.